53 research outputs found
Outcomes After 25 Years of Periodontal Treatment and Maintenance of a Patient Affected by Generalized Severe Aggressive Periodontitis
No full textThis report describes the long-term outcomes of nonsurgical periodontal therapy and supportive periodontal treatment (SPT) of a 21-year-old patient affected by generalized aggressive periodontitis at multiple teeth with a compromised prognosis. After 25 years of SPT, no teeth had been extracted and no periodontal pockets associated with bleeding on probing were present. Radiographic analysis showed an improvement in infrabony defects, demonstrating longterm improvement is possible with nonsurgical periodontal treatment provided that smoking is not present and the patient is included in a strict SPT
Bone modelling at fresh extraction sockets: immediate implant placement versus spontaneous healing. An experimental study in the beagle dog
No full textObjectives: The purpose of this investigation is to describe histologically the undisturbed healing of fresh extraction sockets when compared to immediate implant placement.Methods: In eight beagle dogs, after extraction of the 3P3 and 4P4, implants were inserted into the distal sockets of the premolars, while the mesial sockets were left to heal spontaneously. Each animal provided four socket sites (control) and four implant sites (test). After 6 weeks, animals were sacrificed and tissue blocks were dissected, prepared for ground sectioning.Results: The relative vertical buccal bone resorption in relation to the lingual bone was similar in both test and control groups. At immediate implant sites, however, the absolute buccal bone loss observed was 2.32 (SD 0.36) mm, what may indicate that while an apical shift of both the buccal and lingual bone crest occurred at the implant sites, this may not happen in naturally healing sockets.Conclusions: The results from this investigation showed that after tooth extraction the buccal socket wall underwent bone resorption at both test and control sites. This resorption appeared to be more pronounced at the implant sites, although the limitations of the histological evaluation method utilized preclude a definite conclusion
Fresh extraction socket: Spontaneous healing vs. immediate implant placement
No full textAim: To evaluate the impact that immediate implant placement may have on bone remodelling in comparison with adjacent sockets left to heal spontaneously. Materials and methods: In a beagle dog model (N = 16 dogs), mandibular premolars were extracted, and implants were placed in each distal socket (test) with the corresponding mesial site left to heal undisturbed (control). Healing was assessed measuring both the vertical distance between buccal and lingual crest (B'L') and the width of buccal and lingual walls at different levels. Five healing periods were evaluated. Differences between means for each variable and for each healing period between test and control were compared (Kruskal-Wallis test; Friedman test). Results: At 2 and 8 weeks of healing, the B'L' distance revealed significant higher values at test compared to control sites, being this difference three times higher at the end of the study (P < 0.05). In the test group, the width of the crest was reduced between baseline (0.37 [0.04]) and 8 weeks healing (0.13 [0.64]), demonstrating a 62% reduction of the initial width. These differences were not observed in the control group. Conclusions: Immediate implant placement into fresh extraction sockets may jeopardize the vertical bone remodelling of the socket. Furthermore, a tendency towards greater buccal horizontal resorption was observed in the most coronal aspect of the buccal bone crest
Early healing of the alveolar process after tooth extraction: An experimental study in the beagle dog
No full textAim To describe the early healing events in the alveolar socket during the first 8 weeks of spontaneous healing after tooth extraction. Materials and Methods 16 adult beagle dogs were selected and five healing periods were analysed (4 h, 1 week, 2 weeks, 4 weeks, 8 weeks). Mandibular premolars were extracted and each socket corresponding to the mesial root was left to heal undisturbed. In each healing period, three animals were euthanatized, each providing four study sites. Healing was assessed by descriptive histology and by histometric analysis using as landmarks: the vertical distance between buccal and lingual crest (B'L') and the width of buccal and lingual walls at three different levels. Differences between means for each variable for each healing period were compared (ANOVA; p < 0.05). Results B'L' at baseline was 0.45 (0.18) mm and decreased during the healing period to a final value of 0.18 (0.08) mm. The lingual width (Lw) remains almost unchanged while the buccal width (Bw) at 1 (Bw1) and 2 (Bw2) mm was reduced in about 40% of its initial value. Conclusions Minor vertical bone reduction in both the buccal and lingual socket walls were observed. A marked horizontal reduction of the buccal bone wall was observed mostly in its coronal aspect. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Factors affecting radiographic marginal bone resorption at dental implants in function for at least 5 years: A multicenter retrospective study
No full textObjectiveTo evaluate the influence of patient and implant-related factors on the changes of marginal bone levels (MBL) at implants with a follow-up >= 5 years.Materials and MethodsAt baseline (within 6 months from prosthetic insertion) and long-term (>= 5 years after implant placement) visits, interproximal (mesial and distal) MBL were radiographically evaluated. To analyze factors predicting MBL change, the site (either mesial or distal) showing the highest MBL change (hChMBL site) was identified for each implant. Multilevel regression models were built to explain MBL change as well as the probability for a bone loss >= 2 mm at long-term.Results942 implants in 312 patients with a mean follow-up of 8.02 +/- 2.5 years were analyzed. MBL change was significantly predicted by baseline MBL, oral bisphosphonate (BP) intake, history of periodontitis, diabetes, and super-hydrophilic implant surface. Higher risk for a bone loss >= 2 mm was observed in patients with history of periodontitis (OR = 9.52, 95% CI 0.72-3.79) and taking BP (OR = 6.84, 95% CI 0.21-3.63). Mandibular implants had higher odds for bone loss >= 2 mm compared to maxillary implants (OR = 3, 95% CI 0.39-1.87).ConclusionsThe findings of the present study contribute to the identification of specific clinical scenarios at higher risk for implant-supporting bone loss that need to be strictly monitored during maintenance
Immediate implants at fresh extraction sockets: an experimental study in the beagle dog comparing four different implant systems. Soft tissue findings
No full textP>ObjectivesTo evaluate whether different implants placed immediately upon tooth extraction may affect the dimension and composition of the peri-implant soft tissues.Material and MethodsEight beagle dogs received implants randomly installed into the distal socket of 3P3 and 4P4. Four commercially available implant systems were evaluated: 3i Osseotite Certain straight; Astra MicroThread (TM)-OsseoSpeed (TM); Thommen SPI Element (R); and Straumann ITI standard. Each animal provided four test implant sites. All animals were sacrificed 6 weeks after implant placement, providing specimens for the evaluation of the soft tissue dimensions by histometric analysis.ResultsThe biological width at 6 weeks after implant placement consisted of a junctional epithelium measuring between 2 and 2.7 mm and a connective tissue component between 1 and 1.8 mm with no statistical differences among the four implant systems.ConclusionThis study failed to demonstrate differences in the soft tissue healing outcome when placing four different implant systems into fresh extraction sockets. Nevertheless, the length of the epithelium achieved with the four implant systems is longer than what has been reported when placing implants in healed-ridge experimental models
Clinical and histological healing of a new collagen matrix in combination with the coronally advanced flap for the treatment of Miller class-I recession defects: an experimental study in the minipig
No full textAim: To describe the histological and clinical outcomes of the use of a xenogeneic collagen matrix (CM) in combination with the coronally advanced flap (CAF) in the treatment of localized Miller class-I gingival recessions.Material and Methods: Gingival recession defects were surgically created on 12 minipigs. The defects were randomly treated with either the CAF procedure and the interposition of a CM (test) or the CAF alone (control). Clinical and histological outcomes at 1, 4 and 12 weeks were evaluated.Results: Histometrically, in the test group, there was a shorter junctional epithelial dimension [2.26 (SD 0.23) mm] compared with the control [2.79 (SD 0.77) mm]. On the contrary, the amount of newly formed cementum was larger in the test group [1.08 (SD 0.41) mm] than in the control group [0.75 (SD 0.25) mm], although the differences were not statistically significant.Conclusions: Both techniques rendered similar clinical outcomes, achieving complete root coverage at the end of the study. Nevertheless, the CM graft attained more tissue regeneration, characterized by a shorter epithelium and a larger new cementum formation. The use of a xenogeneic CM resulted in the incorporation of the xenograft within the adjacent host connective tissues in the absence of significant inflammation
Quality of reporting of experimental research in implant dentistry. Critical aspects in design, outcome assessment and model validation
No full textAbstract Objective The aim was to assess the quality of reporting of experimental research in implant dentistry by a critical evaluation of study design, outcome assessments and model validation. Material & Methods An online search was performed using the MEDLINE. Experimental studies performed in both animals and humans were included. A’stratified random sample of the included studies was extracted and used for quantitative and qualitative analyses. Modified versions of the ARRIVE guidelines were used for quality assessment. Results A total of 982 papers were eligible and used for quantitative analyses. A’stratified random sample of 193 publications was extracted. The dog model was the most used experimental model whereas experimental studies on humans were few. Intra-oral experimental sites dominated in human, monkey, dog and mini-pig studies. Extra oral sites dominated in rabbit, rodent and goat/sheep studies. Studies on the pathogenesis and treatment of peri-implant diseases were few. Conclusion Different animal models, experimental protocols and methods of analysis have been used to address different areas of experimental research in implant dentistry. Standardized designs for investigations within this type of experimental research seem to be lacking. Furthermore, in many of these studies there were limitations in reporting on methodology and statistical methods
Remodelación de los tejidos blandos alrededor de implantes inmediatos y diferidos.Estudio experimental en perros Beagle.
No full textAntecedentes: Los protocolos de implantes inmediatos (tipo 1) y diferidos (tipo 2) son considerados unánimemente como las dos alternativas principales para el reemplazo de un diente desahuciado. Sin embargo, todavía falta una comparación directa de los dos, sobre la organización de los tejidos perimplantarios, tanto duros como blandos.
Objetivos: Investigar la presencia de diferencias significativas en la altura y el grosor del tejido blando alrededor de implantes inmediatos y precoces en fases de cicatrización temprana y tardía.
Métodos: 8 perros de raza Beagle han recibido 32 implantes inmediatos (test) y 32 implantes diferidos (control). Los implantes inmediatos fueron puestos en los alvéolos mésiales de 3P3 y 4P4, mientras los diferidos fueron puestos en los alveolos mésialed de 1P1 y 2P2, 8 semanas después de la emi-sección de los dientes y la extracción de las raíces mésiales. Los implantes diferidos Los perros fueron sometidos a eutanasia después 2 y 8 semanas para el análisis histológico. Mitad de los sitios implantares fueron procesados con técnica calcificada y la otra mitad con técnica descalcificada.
Resultados: En las secciones descalcificadas, la anchura biológica perimplantaria fue significativamente mayor a las 2 semanas (I-J = 1,5 mm; p = 0,028) y casi significativamente mayor a las 8 semanas (I-J = 1 mm; p = 0,088). Sin embargo, no se observaron diferencias significativas en las secciones calcificadas. Con respecto al grosor del tejido, se observaron valores consistentemente más altos en el grupo control a las 2 semanas (de 0,69 a 1,51 mm), pero esta diferencia se redujo abundantemente a las 8 semanas (0,2 a 0,6 mm) y casi siempre perdió significación estadística.
Conclusiones: A las 8 semanas de cicatrización, la formación de la mucosa perimplantaria alrededor de implantes inmediatos y diferidos fue asociada a ninguna diferencia relevante en el espesor del tejido blando. En las secciones descalcificadas, se observó una anchura biológica approx. mayor de 1 mm en los implantes inmediatos. Dicha diferencia implicaba tanto el epitelio de unión como el tejido conectivo de aprox. 0,5 mm cada uno.Background: The immediate (type 1) and delayed (type 2) implant protocols are unanimously considered as the two main alternatives for the replacement of a hopeless tooth. However, a direct comparison investigating the biological implications of these two alternatives, both at the hard and soft tissues level, is still lacking.
Objective: To inquire whether significant differences in biologic width and soft tissues thickness can be detected among immediate and early implants at early and late stages of healing.
Methods: 8 beagle dogs received 32 immediate (test) and 32 early (control) implants. Immediate implants were placed at the mesial socket of 3P3 and 4P4 whereas Delayed implants were placed 8 weeks after teeth emi-section and extraction of either 2P2 and 1M1,. The implant platform was placed at the level of the marginal buccal bone crest. Animals were sacrificed at 2 and 8 weeks for histological examination. Half of the implant sites were processed for ground sectioning and the other half for decalcified sectioning in paraffin.
Results: In the decalcified sections, the peri-implant biologic width was significantly higher at 2 weeks (I-J = 1,5mm; p= 0,028) and almost significantly higher at 8 weeks (I-J = 1mm; p = 0.088). However, no significant differences were observed in the ground sections. With respect to tissue thickness, consistently higher values were observed in the control group at 2 weeks (from 0.69 to 1.51mm). However, this difference was abundantly reduced at 8 weeks (0.2 to 0.6 mm) and resulted to be non significant at most reference points.
Conclusions: Results from this study suggest that, at 8 weeks of healing, the dimensions of the perimplant mucosa around immediate and delayed implants is associated with no relevant differences in soft tissue thickness. An approx. 1mm larger biological width was associated with in immediate implants in decalcified sections. Such difference involved both the junctional epithelium and the connective tissue for approx. 0.5mm each.Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaFALSEunpu
Patient-reported outcomes and aesthetic evaluation of root coverage procedures: a 12-month follow-up of a randomized controlled clinical trial
No full textAim: To assess patient-reported outcome measures (PROMs), aesthetics and stability of root coverage procedures from a previous 6-month RCT after 1 year. Material & Methods: Forty-five patients (90 recessions) had received a coronally advanced flap (CAF = control) only or a xenogeneic collagen matrix in addition (CAF + CMX = test). Visual analogue scales (VAS) and questionnaires were used for PROMs and the root coverage aesthetic score (RES) for professional aesthetic evaluations. Results: VAS scores (patient satisfaction) amounted to 8.58 ± 1.86 (test) versus 8.38 ± 2.46 (control). Six patients preferred CAF + CMX concerning surgical procedure and aesthetics, six preferred CAF and 29 were equally satisfied. RES was 7.85 ± 2.42 for the test group versus 7.34 ± 2.90 for the controls. Root coverage (RC) was 76.28% for test and 75.05% for control defects. The mean increase in keratinized tissue width was higher in test (from 1.97 to 3.02 mm) than in controls (from 2.00 to 2.64 mm) (p = 0.0413). Likewise, test sites showed more gain in gingival thickness (0.52 mm) than control sites (0.27 mm) (p = 0.0023). Compared to 6 months, clinical outcomes were stable. Conclusions: Results for PROMs, RES and RC did not significantly differ between treatment groups. Thickness and width of keratinized tissue were enhanced following CAF + CMX compared to CAF alone
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